CHANGE: The antidote to complacency

For many of us, change is difficult, even if we know, intellectually, that we need to do things differently. Organizations, such as IDNs, find this to be true. So do individuals, including contracting executives.

In their 2010 book “Switch: How to Change Things When Change is Hard”, authors Chip Heath and Dan Heath investigate why change is so difficult to pull off, and how to do it anyway.

The Heaths base their book on an analogy of an elephant and his or her rider. “Perched atop the Elephant, the Rider holds the reins and seems to be the leader. But the Rider’s control is precarious because the Rider is so small relative to the Elephant. Anytime the six-ton Elephant and the Rider disagree about which direction to go, the Rider is going to lose.”

In the analogy, the Rider represents our intellect, and the Elephant represents our emotions. “The Elephant’s hunger for instant gratification is the opposite of the Rider’s strength, which is the ability to think long-term, to plan, to think beyond the moment,” they write.

You’d think that once the Rider figured out why change is needed and how to bring it about, change would occur. But we are, after all, human, say the Heaths. So it doesn’t happen that way. In fact, the Rider in us tends to overanalyze and overthink things. The Elephant provides the energy. To effect change, you’ve got to appeal to both. The book is full of anecdotes about individuals and companies that have done just that.

Perhaps the most confounding of the Heaths’ beliefs is that knowledge doesn’t change anything. Just knowing the cause of dysfunction in our business or relationships doesn’t mean we can change it. They point to another flaw of analysis: “The Rider loves to contemplate and analyze and, making matters worse, his analysis is almost always directed at problems rather than at bright spots.” “[Bright spots] are so essential, because they are our best hope for directing the Rider when you’re trying to bring about change.”

So rather than look for big system problems, look for bright spots that are working, and do those things, advise the authors. “To pursue bright spots is to ask the question, ‘What’s working, and how can we do more of it?’ [T]his obvious question is almost never asked. Instead, the question we ask is more problem-focused: ‘What’s broken, and how do we fix it?’”

According to the Heaths, strong leadership is a necessity for change to take place. The leader – such as the vice president or director – needs to provide crystal-clear guidance for the direction (the authors call it a “destination postcard”) in which he or she wants the organization or department to move. And he has to take it one step further: He has to script the specific behavior he or she wants to see in tough moments, when it’s so easy for people to fall into old, self-defeating patterns of behavior.

“When you describe a compelling destination, you’re helping to correct one of the Rider’s great weaknesses – the tendency to get lost in analysis,” they say.

“Destination postcards do double duty: They show the Rider where you’re headed, and they show the elephant why the journey is worthwhile.”

The book is “Switch: How to Change Things When Change is Hard”, by Chip Heath and Dan Heath, published in 2010 by Broadway Brooks, New York.

Mark Thill is the Editor of The Journal of Healthcare Contracting and has been reporting on healthcare supply chain issues since 1985. He is a graduate of Dominican University in River Forest, Ill., and he received a master's degree in journalism from Northwestern University in Evanston, Ill.